Background - The goal of this project, with a focus on commercial buildings in California, wasto develop a new framework for evidence-based minimum ventilation rate (MVR) standards that protect occupants in buildings while also considering energy use and cost. This was motivated by research findings suggesting that current prescriptive MVRs in commercial buildings do not provide occupants with fully safe and satisfactory indoor environments.Methods - The project began with a broad review in several areas – the diverse strategies now used for standards or guidelines for MVRs or for environmental contaminant exposures, current knowledge about adverse human effects associated with VRs, and current knowledge about contaminants in commercial buildings, including their their presence, their adverse human effects, and their relationships with VRs. Based on a synthesis of the reviewed information, newprinciples and approaches are proposed for setting evidence-based VRs standards for commercial buildings, considering a range of human effects including health, performance, and acceptability of air.

Results – A review and evaluation is first presented of current approaches to setting prescriptive building ventilation standards and setting acceptable limits for human contaminant exposures in outdoor air and occupational settings. Recent research on approaches to setting acceptable levels of environmental exposures in evidence-based MVR standards is also described. From a synthesis and critique of these materials, a set of principles for setting MVRs is presented, along with an example approach based on these principles. The approach combines two sequential strategies. In a first step, an acceptable threshold is set for each adverse outcome that has a demonstrated relationship to VRs, as an increase from a (low) outcome level at a high reference ventilation rate (RVR, the VR needed to attain the best achievable levels of the adverse outcome); MVRs required to meet each specific outcome threshold are estimated; and the highest of these MVRs, which would then meet all outcome thresholds, is selected as the target MVR. In a second step, implemented only if the target MVR from step 1 is judged impractically high, costs and benefits are estimated and this information is used in a risk management process. Four human outcomes with substantial quantitative evidence of relationships to VRs are identified for initial consideration in setting MVR standards. These are: building-related symptoms (sometimes called sick building syndrome symptoms), poor perceived indoor air quality, and diminished work performance, all with data relating them directly to VRs; and cancer and non-cancer chronic outcomes, related indirectly to VRs through specific VR- influenced indoor contaminants. In an application of step 1 for offices using a set of example outcome thresholds, a target MVR of 9 L/s (19 cfm) per person was needed. Because this targetMVR was close to MVRs in current standards, use of a cost/benefit process seemed unnecessary. Selection of more stringent thresholds for one or more human outcomes, however, could raise the target MVR to 14 L/s (30 cfm) per person or higher, triggering the step 2 risk management process. Consideration of outdoor air pollutant effects would add further complexity to the framework. For balancing the objective and subjective factors involved in setting MVRs in a cost-benefit process, it is suggested that a diverse group of stakeholders make the determination after assembling as much quantitative data as possible.

Discussion - Minimum VR standards can consider evidence associating VRs with human outcomes both directly (e.g., building-related symptoms), even when specific causal indoor contaminants are unidentified; and indirectly through VR-influenced indoor concentrations of specific indoor contaminants. Prior VR standards have considered limited evidence of the first type, but not that of the second type, and little evidence of both types has been available. The principles and approaches suggested here, although more complex than current approaches, would provide more explicit protection for occupants of commercial buildings from adverse effects of indoor contaminants, while also considering VR-related costs. Ideally, in the future, this process would include separate reference VRs for occupant-proportional and building- proportional MVRs, but sufficient data are not yet available. The suggested new framework for VR standards also highlights the need for substantial new data on the direct and indirect relationships of VRs with adverse human outcomes.